Heat exhaustion treatment in Phuket
Thirty-three degrees with ninety percent humidity does not feel like thirty-three degrees, and sweat that will not evaporate cools nobody. Heat exhaustion treatment in Phuket is straightforward when caught early and matters enormously, because the condition it turns into kills people.
What it feels like
Heavy sweating, skin that has gone cool and clammy, and a pulse that is fast but weak. Weakness out of proportion to what you have been doing.
Headache, nausea, dizziness on standing, and muscle cramps in the legs or abdomen. Sometimes a temperature slightly raised but below forty.
The thing that marks it out is that the person is still entirely with you. They are miserable and unsteady, but they know where they are and can answer sensibly.
What to do immediately
Out of the sun, into shade or air conditioning, and lying down with the legs raised. That much on its own reverses a good proportion of cases.
Get clothing off or at least loosened, wet the skin down and put a fan on it. Ice packs work best tucked into the armpits, against the sides of the neck and at the top of the inner thighs, since the blood passing those points is close enough to the surface to be cooled on its way round.
Cool fluids by mouth, sipped steadily, ideally with salts in them. Not iced water gulped down, which causes cramps and vomiting.
Improvement should be obvious inside thirty minutes. If it is not, that changes the situation entirely.
Heat stroke, which is a different emergency
A core temperature above forty, with confusion, slurred speech, aggression, seizures or loss of consciousness. Skin often hot and dry because sweating has failed altogether.
This is a medical emergency and it damages organs within minutes. Ring 1669 and start cooling immediately — cold water, ice, wet sheets, anything available.
Do not wait to see whether it settles. The single distinguishing feature is the state of the person’s mind, and confusion is the line — see emergency medical care.
Why this island in particular
Humidity is what does it. Sweat cools you by evaporating, and in air already saturated with water it simply runs off, so the body’s main cooling mechanism stops working.
March to May is the hottest stretch, but the wet season can be worse for this because the humidity is higher still.
The heat index — what the combination actually feels like — regularly exceeds forty here on days when the thermometer says thirty-three.
Who it happens to
Arrivals from cold climates in their first few days, before any acclimatisation has happened.
- Anyone drinking alcohol in the afternoon sun
- People on long-tail boat trips with no shade and no water
- Riders and cyclists, who are moving and therefore feel cooler than they are
- Children, who overheat faster and complain later
- Older travellers and anyone on blood pressure or diuretic medication
- Anyone who has had diarrhoea or vomiting in the last day or two
Acclimatisation takes one to two weeks. Very little of a holiday is spent acclimatised.
Fluid, and getting it right
Two to three litres a day at minimum, more if you are active or sweating heavily, and considerably more than feels necessary.
Salt matters as much as water. Heavy sweating loses sodium, and drinking large amounts of plain water alone can dilute what is left and produce its own problems.
Rehydration salts, coconut water or salty food alongside plain water. Urine that is pale straw is the practical indicator; dark and infrequent means you are behind — see dehydration treatment.
When it needs a drip
Where somebody cannot keep fluid down, or where an hour of shade and sipping has produced no real improvement.
Intravenous fluid with the right electrolytes corrects it quickly, and the difference is usually obvious within the hour — see IV drips.
Bloods are worth checking where it has been severe, because sodium and kidney function can both be disturbed — see blood tests.
Alcohol, which makes all of it worse
Alcohol is a diuretic, so it removes fluid at exactly the point you need to be keeping it. It also impairs judgement about how hot you have become.
An afternoon of drinking in direct sun is the single most reliable route to heat exhaustion here, and it is why beach clubs produce so many cases.
The morning after is its own version of the same problem, and the two overlap heavily — see hangover treatment.
Children and the heat
Children have a larger surface area relative to their size, sweat less efficiently, and are far worse than adults at noticing they are overheating.
Irritability, unusual quietness, flushed skin, refusing drinks or being difficult to rouse. Any of those on a hot day means shade and fluid immediately.
Never leave a child in a parked car here, even briefly and even in shade. Interior temperatures become lethal in minutes — see paediatric care.
Avoiding it in the first place
Stay out of direct sun between eleven and four. Plan the beach for morning and late afternoon, which is also when it is more pleasant anyway.
Light loose clothing, a wide hat, and shade whenever it is available. Water carried rather than water intended to be bought later.
Build up gradually over the first week. Doing everything on day two is how people spend day three indoors.
Getting seen
A doctor can attend your hotel or villa, cool and rehydrate you there, and check for anything more serious going on — see doctor hotel visits.
Bang Tao, Kata and Patong take walk-ins at any hour, which matters because the worst of this shows itself late in the afternoon.
Anything suggesting heat stroke goes to a hospital, and that transfer is arranged rather than suggested — see hospital transfer.
Frequently asked questions
How do I tell exhaustion from heat stroke?
The mind. Heat exhaustion leaves someone miserable but lucid. Confusion, slurred speech or unconsciousness means heat stroke and 1669 immediately.
What do I do first?
Shade, lying down with legs raised, cool water on the skin, ice at neck and armpits, and cool salty fluid sipped steadily.
How long should recovery take?
Obvious improvement within about thirty minutes. If there is none, it needs assessing rather than more waiting.
How much should I be drinking?
Two to three litres a day minimum, more when active. Pale straw urine means you are keeping up; dark and infrequent means you are not.
Is plain water enough?
Not with heavy sweating. Sodium is lost too, and large volumes of plain water alone can dilute what remains. Use salts or salty food alongside.
Why is it worse here than the temperature suggests?
Humidity. Sweat cools by evaporating, and in saturated air it just runs off, so the body’s main cooling system stops working.
My child has been irritable and flushed all afternoon.
Get them into shade with fluids now. Children overheat faster and are far worse at noticing it than adults.
Can somebody come to the hotel?
Yes, at any hour — cooling, rehydration, a drip if needed, and a check for anything more serious.
Three clinics, none of which close
English-speaking doctors, on duty 24 hours a day. Phuket is bigger than visitors expect and the traffic is worse than the map suggests, so Takecare Medical Clinic works from three separate buildings rather than one: Bang Tao on the north-west coast, Kata in the south, and Patong between them. Each is open every hour of every day, takes people without an appointment, and asks nothing about residency or referrals.
Beyond the island, Takecare Medical Clinic is one of the Takecare Clinic group‘s clinics working across Phuket, Krabi and Chon Buri. That matters mainly for what happens afterwards: move on mid-treatment and the next clinic already holds the notes, so a handover is a call between colleagues rather than a folder you carry through an airport.
Getting seen, and how to choose a branch
There is somebody on the end of +66 81 718 9080 or WhatsApp 24 hours, every day. Say what has gone wrong and the reply will be honest about which of three things you are dealing with: come in now, this will keep until the morning, or skip us entirely and go where there is a surgeon. No appointment exists to be made, and there is no hour at which asking is a nuisance.
Pick whichever branch is nearest rather than whichever sounds largest — they run the same hours and carry the same equipment. Patong suits the west-coast beaches and Bangla Road, Kata covers Karon and the south, and Bang Tao serves Layan, Surin and Cherngtalay. Cannot get out to a clinic? Ask for a doctor hotel visit instead and somebody comes to your room. And if what you need turns out to be beyond any clinic, referral and hospital transfer is arranged from the same conversation. You are made stable before anybody moves you, a colleague rings ahead so the team on the other end knows what is arriving, and the transport is organised for you rather than handed over as one more thing to sort out.